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The purpose of this paper is to describe changes in my treatment of abused children over the several decades of my practice (33 years). These changes came about in response to several changes in the world outside my office. These outside changes included (a) the published works of several developmental theorists, (b) the rise in recognition of child abuse, (c) changes in the legal and medical communities about the management of abusers, and (d) the rise in parental concern about child abuse by professionals.
In the state of my residence, psychiatrists are liable to malpractice suits up to 7 years after discovery or 7 years after the death of the psychiatrist. In the process of preparing for retirement I am summarizing all my records for microfilming. A secondary gain from this effort is a necessary review of case records.
To compare my changes in management of child patients, I have chosen the first 5 years of practice (1953-1958), which were years before completing my analytic training, the next 5 years (1958-1963), my first years as an analyst, and the past 5 years (1985-1990).
The population to be described is the smallest subpopulation in